Objectives: The objective of this study was to assess the existing
theoretical and empirical literature examining the link between “local production” of pharmaceuticals and medical devices and increased local access to
these products. Our preliminary hypothesis is that studies showing a robust relationship between local production and access to
medical products are sparse, at best.

Methods: An extensive literature search was conducted using a wide variety of
databases and search terms intending to capture as many different aspects of this issue as possible. The results of the search were
reviewed and categorized according to their relevance to the research question. The literature was also reviewed to determine the
rigor used to examine the effects of local production and what implications these experiences hold for other developing countries.

Results: Literature addressing the benefits of local production and the link
between it and access to medical products is sparse, mainly descriptive and lacking empirical evidence. Of the literature we reviewed that
addressed comparative economics and strategic planning of multinational and domestic firms, there are few dealing with emerging markets
and lower-middle income countries and even fewer that compare local biomedical producers with multinational corporations in terms
of a reasonable metric. What comparisons exist mainly relate to prices of local versus foreign/multinational produced
medicines.

Conclusions: An assessment of the existing theoretical and empirical
literature examining the link between “local production” of pharmaceuticals and medical devices and increased local access to these products
reveals a paucity of literature explicitly dealing with this issue. Of the literature that does exist, methods used to date are
insufficient to prove a robust relationship between local production of medical products and access to these products. There are mixed
messages from various studies, and although the studies may correctly depict specific situations in specific countries with reference to
specific products, such evidence cannot be generalized. Our review strongly supports the need for further research in understanding the
dynamic link between local production and access to medical products.